Improving Revenue Integrity Under PDPM - On-Demand

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Improving Revenue Integrity Under PDPM - On-Demand

Product Code: YLHA092519A

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Improving Revenue Integrity Under PDPM

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Available ON-DEMAND

Presented on: 
Wednesday, September 25, 2019 

Presented by: Maureen McCarthy, BS, RN, RAC-MT, QCP-MT, DNS-MT, RAC-MTA

A new billing structure will be implemented with PDPM on October 1, 2019. To prepare for this change, all staff involved in the billing and reimbursement process, from MDS coordinators to business office staff, should understand how the new payment methodology will impact revenue.

During this 60-minute webinar, Maureen McCarthy, BS, RN, RAC-MT, QCP-MT, DNS-MT, RAC-MTA, will explain the basics of the PDPM structure and how reimbursement will be calculated differently under a system driven by patient characteristics, rather than therapy minutes. Attendees will learn the effect PDPM will have on a facility’s revenue, MDS documentation’s new role in producing a clean claim, and how to ensure accurate reimbursement by including appropriate adjustment factors for certain components.

At the conclusion of this program, participants will be able to:

  • Identify six components of PDPM rates
  • Understand those components with variable per diem adjustment factors
  • Identify HIPPS code indicators that will be used under PDPM
  • Recognize denial red flags and opportunities for correction on the claim
  • Explain MDS documentation’s implications on the claim


  • SNF Part A billing
    • Resident classification system and payment rate components
    • Calculating per diem rates
    • New HIPPS modifiers
  • Projecting expenses and revenue
    • Preadmission screening
    • Effective capture of diagnoses and condition categories
    • MDS accuracy
  • Triple-check and mitigating claim audits
    • Medicare meeting
    • Coding accuracy and medical review
    • Return to provider codes
  • Tools
    • CMS crosswalks for clinical mapping and NTA

Who Should Listen?

  • Billers
  • Billing specialists
  • Business office managers
  • MDS coordinators
  • Chief financial officers and administrators
  • Vice presidents
  • Accounts receivable staff
  • Chief operations officers
  • Directors of finance/reimbursement
  • Financial analysts
  • Medicare billing managers
  • Revenue cycle managers
  • Presidents
  • Controllers

Meet the Speaker

Maureen McCarthyMaureen McCarthy, BS, RN, RAC-MT, QCP-MT, DNS-MT, RAC-MTA, is president of Celtic Consulting, LLC, and CEO and founder of Care Transitions, LLP, a care coordination service provider. She is also the creator of the McCarthy Method, a documentation improvement system for ADL coding. She and her associates at Celtic Consulting educate and train on clinical reimbursement, quality improvement, compliance, and coding for skilled nursing facilities, state affiliates, and provider organizations. McCarthy has been a registered nurse for 30 years with experience as an MDS coordinator, director of nursing, rehab director, and Medicare biller, and she holds a leadership role in several nationally recognized organizations. She has also authored multiple books for HCPro; most recently she was the co-author of The Five-Star Quality Rating System Technical User’s Guide and the author of Medicare Audits: A Survival Guide for Skilled Nursing Facilities and A SNF’s Guide to Medication Reconciliation and Drug Regimen Review.



Webinar system requirements and program materials: 
To fully benefit from the webinar experience, please note you will need a computer equipped with the following: 

Browser: Microsoft Internet Explorer 6 or later, Firefox, Chrome, or Safari, with JavaScript enabled 
Internet: 56K or faster Internet connection (high-speed connection recommended) 
Streaming: for audio/video streaming, Adobe Flash plug-in or Safari browser on iOS devices 

Prior to the webinar, you will receive an email with detailed system requirements, your login information, presentation slides, and other materials that you can print and distribute to all attendees at your location. 

No problem. The On-Demand version will be available. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times. A $149 value! 

Participation in the webinar is just $149 per site. All materials must be retrieved from the Internet. 

Call your customer service representative toll-free 800-650-6787 or email if you have questions.